Wednesday, 2 July 2008

A walk in the woods

A return to ethical issues today. As ever, what makes a story interesting is when a second story causes you to look at the first in a new way.

The papers today have been looking at a Joseph Rowntree Foundation report that claims a single person needs a minimum of £13,400 gross a year to maintain a good standard of living. That standard will include bottles of wine, film tickets, bird feeders, a mobile phone and a bicycle. It excludes access to a car - apparently this is a luxury, not a necessity.

Meanwhile, in Cardiff, a small girl has Infantile Tay-Sachs disease. In her short life (she's only six) she has needed intensive care five times to get her through chest infections. Doctors apparently want the option not to treat her aggressively when she falls ill. Her parents say she has a right to life. They say (here is where the two stories collide) that she has a "marvellous" quality of life that includes foreign holidays, Centre Parcs and woodlands near by.

Standard of living is not the same as quality of life, of course, but the two are intertwined. You can be poor and happy, being rich doesn't necessarily make you happy. Back in April this year the Telegraph ran a story showing that although Britain is the world's 5th biggest economy it ranks only 17th in the world for quality of life. The Evidence Based Medicine series from the Hayward Group doesn't mention money at all in its definition of quality of life. The Quality of Life Challenge looks only at environmental issues - energy efficiency, lower taxes for "green" homes.

Psychologists consider that there is a heirarchy of needs. Basic needs come first. If you don't have a home and don't know if you'll eat this evening those needs are more pressing that whether or not you've seen the latest film or own a bird feeder. Certain basics need to be in place before we start to focus on the fancier things. Indeed, psychologust Oliver James says this very hankering after the fancier things can actually make us less happy.

So what makes good quality of life and standard of living? Is it a bottle of wine a week, a bird feeder and a trip to the pictures? Is it fast cars , fame and fortune? Or is it a walk in the park? The Telegraph reminds us today that the happiest people on the planet are the Danes. They quote Professor Ron Inglehart as saying "Ultimately, the most important determinant of happiness is the extent to which people have free choice in how to live their lives."

For me, this is the key in all this. Because your idea of happiness, quality of life, standard of living (and these aren't quite synonymous, but are surely intertwined) might be my idea of hell, and vice versa. You may feel that to be happy and have a good quality of life you need the fitness to climb mountains, bungee jump, hang glide, or just go jogging. I'd hate to be subjected to any of those things and would be happy to think I never had to do any of them. So if I were paralysed I might consider my life still to be worth living, but in the same situation you might wish yourself dead.

So you might look at the story of the little girl in Cardiff and feel sorry for her parents who think that having woodland nearby constitutes good quality of life when their daughter has epilepsy, is unable to speak and is almost totally paralysed. Or you applaud a couple who can see happiness in small things.
In the end it perhaps means that only an individual can decide what makes good quality of life for them; to decide when life is worth fighting for or when they would rather die. There can be no formula, policy or guideline to define these decision, which is why the Cardiff case will not be an easy one for the courts to consider.

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